First Nations Home Health Bloghttp://firstnationshomehealth.com/first-nations-home-health-blog/
Wed, 09 Sep 2015 15:48:01 GMTen-usCopyright 2015 First Nations Home Health | Native American Healthcare | Bemidji Caring for Mom & Dadhttp://firstnationshomehealth.com/first-nations-home-health-blog/caring-for-mom-dad/
http://firstnationshomehealth.com/first-nations-home-health-blog/caring-for-mom-dad/Thu, 11 Jun 2015 15:47:40 GMTAmericans are living longer than ever before, and soon older adults will outnumber the young. Who will care for them when they are no longer able to care for themselves? With this aging population how will we adapt as a nation?First Nations Home HealthAmericans are living longer than ever before, and soon older adults will outnumber the young. Who will care for them when they are no longer able to care for themselves? With this aging population how will we adapt as a nation?

Recently, our parent company HealthStar Home Health had the opportunity to work with PBS to identify a family who would be willing to be filmed for a documentary they were working on. The PBS documentary “Caring for Mom & Dad” explores the emotional, health and financial challenges that many family caregivers face each day. We chose a family who has been a part of the HealthStar/First Nations family since 2010 and exemplifies integrity, servant leadership, empathy and altruism.

Alicia and her mother Estella are proud members of a St. Paul Latino community. When Estella suffered a massive stroke following heart surgery, Alicia was forced into the role of full-time caregiver for her mother, basically overnight. Although considered informal caregivers by the government, nearly 1/2 of family caregivers perform medical services traditionally reserved for a nurse. Insurance may cover some expenses, but not everything so families are left with the added expenses to care for their parents. Family caregivers spend an average of $5500 on out-of-pocket costs per month, leaving them to face heavy burdens financially and emotionally.

“The Latino community is very close knit and our family is our nucleus. It is considered an honor and a source of pride to be there for our families during good and challenging times. When a family member is in need, particularly the elderly, we take care of our own. La familia es primero.”, said Nilda Garcia with First Nations Home Health. She goes on to say “as a Latina, I have worked for HealthStar/First Nations for almost 7 years and I am so proud that we are able to provide healthcare services while respecting the unique needs of our culturally diverse clientele. Seeing them happy is our most precious reward.”

Ana Diaz is a medical advocate with Payne-Phalen Elders who visits Latino caregivers and their families in their homes, including Alicia and Estella. She is known as the eyes and ears of the aging St. Paul community she serves and is considered a ‘geriatric angel’ to many. Ana helps working caregivers by taking their family members to their doctor appointments, along with being an advocate for them with the county, HMO’s and the nursing homes. “No matter what the chronic disease is, Latino caregivers are facing several unique challenges. Latino caregivers are often less aware of the services that are available in the community, this sometimes is due to a language barrier and sometimes due to their lack of knowledge of the services. Another significant challenge is that the Latino community is less likely to look for nursing home placement for their loved ones. These factors together can add up to an overwhelming role for caregivers” said Ana. Ana strongly believes “faith also plays a very important role. They will pray and believe that everything is going to be ok. While faith sustains people, they often could still benefit from some respite from their caregiving role and benefit from community supports!”

Take some time to watch the PBS documentary and see what our nation is facing with this crisis in caregiving that is upon us.

Today, family caregivers provide 90% of the assistance, even while they struggle to balance careers and their own family. Caregiving averages 4 years. For an Alzheimer’s patient caregiving is 4-8 years and can last as long as 20 years. The rate of Alzheimer’s is expected to triple by the year 2050. That is a heavy load to carry and many struggle financially.

Since 1950, we have added more than a decade to the lifespan of Americans. But as the golden years span out, seniors 65+ suffer from multiple illnesses. Data from the 2014 U.S. Census Bureau show there are 76.4 million baby boomers who are all going to get old at the same time. We are about to have the largest older population we’ve ever had in the history of this country and they are people who want to live at home or independently in their communities, but there is no support infrastructure in place. We are a society that hasn’t adequately accounted for family caregiving work and now we are at a point given all these changes where that is simply not sustainable.

]]>Mental Health - How Can We Remove The Stigma?http://firstnationshomehealth.com/first-nations-home-health-blog/mental-health-how-can-we-remove-the-stigma/
http://firstnationshomehealth.com/first-nations-home-health-blog/mental-health-how-can-we-remove-the-stigma/Fri, 29 May 2015 19:14:10 GMTFirst Nations Home HealthThe numbers are staggering. According to the National Alliance on Mental Illness (NAMI), 1 in every 5 adults in America live with a mental health condition. Approximately 13.6 million adults in America live with a serious mental illness, and one-half of all chronic mental illness begins by the age of 14; three-quarters by the age of 24. Recently, Yahoo News reported a study from 2014 by the American College Health Association finding there is an epidemic of depression and anxiety among college students. Almost 30% of college students reported feeling depressed at some point over the past year and 54% of students reported feeling overwhelming anxiety.

For those who live with mental illnesses, their conditions have been kept secret and often go untreated for fear of embarrassment. There is a stigma associated with mental illness that is furthered when one takes medication to treat the illness. Whether it is depression, anxiety, bipolar disorder, or another form of mental illness, it can be debilitating and should not go untreated. Help those suffering by learning what a mental illness is, the causes, and what you can do to ease the stigma surrounding this.

HealthStar posed this question on Facebook: “What do you think is the most misunderstood thing about mental illness?” Here are some of the top answers from our followers:

that it affects everyone differently and it comes in all forms and begins at any age

people don’t realize it can be treated

mentally ill people are potentially violent

society’s lack of information and education on mental illnesses cause the stigma to grow

talking about mental illness and being available to listen goes a long way - remove the awkward silence

“Make it OK” is a local campaign created to reduce the stigma of mental illness. Their mission is to get people to stop the silence, share stories, and dispel the myths surrounding mental illness. The people behind makeitok.org are changing the hearts and minds about the misconceptions of mental illness by encouraging open conversations and education on the topic, along with encouraging people to seek support when needed. Treatments for mental illnesses are available. The more everyone knows about mental illness, the more understanding and supportive we, as a society, can be.

The Make it OK website offers good, basic, information like what a mental illness is and is not, and what a mental illness can be caused by. They also offer great tips for talking to someone who struggles with mental illness. If a loved-one has told you they are suffering, ask questions, show concern, and most importantly, listen. Mental illnesses are treatable health conditions but people are still afraid to talk about it due to shame, misunderstanding and negativity, amongst other reasons. Help remove the stigma surrounding mental illness and its treatment by learning, listening and keeping the conversation moving.

First Nations looks at how the individual’s mental illness affects their functioning in various aspects of their lives. They may have depressive symptoms that interfere with independent living, self-care, school, housing and even transportation. The services we provide are community based. This allows our caregivers to go out into the community and meet the individual where they are so they can be as independent and functional as possible within their communities. First Nations strives to remove the stigma by teaching those living with mental illnesses and their family members a variety of skills that can help with independent living and social situations.

Getting educated and helping to raise awareness of mental health conditions can break down obstacles and improve the recovery for the millions of Americans who suffer from a mental illness. If we join together as a society, people living with mental illnesses will be treated with respect and acceptance.

]]>Memory Concerns? Take a Proactive Approachhttp://firstnationshomehealth.com/first-nations-home-health-blog/memory-concerns-take-a-proactive-approach/
http://firstnationshomehealth.com/first-nations-home-health-blog/memory-concerns-take-a-proactive-approach/Mon, 11 May 2015 14:37:10 GMTOur health care model transitioned to an innovative, proactive approach over the past several years. A focus on the areas of diet, exercise, preventative clinical services, and a high emphasis on monitoring areas of concern is shifting the way care is delivered. While strides have been made in these areas, it is rare that changes to one’s memory are met with such a proactive approach.First Nations Home HealthOur health care model transitioned to an innovative, proactive approach over the past several years. A focus on the areas of diet, exercise, preventative clinical services, and a high emphasis on monitoring areas of concern is shifting the way care is delivered. While strides have been made in these areas, it is rare that changes to one’s memory are met with such a proactive approach. So often today outreach for support is not initiated until a critical event such as financial loss, exploitation, wandering, or failure to thrive has occurred. As a comprehensive provider of home health care, First Nations Home Health knows firsthand that early detection of memory issues leads to early intervention, and the ability for family to plan together.

The reasons for ignoring memory changes could include embarrassment, denial, and fear, so it is understandable why many may fall into this critical misstep. A typical response from an individual who notices changes to his or her memory is to hide the problem, concerned that a diagnosis of Dementia or Alzheimer’s disease in inevitable. Those close to that individual may harbor similar fears as well. This perpetual cycle makes it difficult to enter into tough dialogue, often resulting in the memory issue developing quietly but profoundly.

What is not well known is that there are many causes for memory loss, many being curable and treatable if recognized early. By regularly integrating memory screenings Health Care professionals can become a catalyst for change and construct critical conversations with their patients around memory concerns. While a memory screening will not diagnose a memory issue, it is the first step in identifying a problem and it will subsequently trigger further diagnostic testing. We need to encourage and empower all those who have concerns that they or their loved ones are experiencing memory changes to discuss those concerns with their health care providers and request memory screening.

If further diagnostic testing reveals a diagnosis of Alzheimer’s or other Dementias, remember, the benefits of earlier diagnosis include improved management of the disease, ability to treat and mange co-existing conditions, and the opportunity to help patients and their families plan ahead. Caring for loved ones with Alzheimer’s or Dementia has a huge impact on their care partner’s ability to achieve work-life balance. According to the coalition for Preparing Minnesota for Alzheimer’s, working caregivers report their caregiving responsibilities affect their work. 57% report arriving to work late. 17% have taken a leave of absence. 10% switch from full-time to part-time hours. 9% left the work place completely as a result of their caregiving responsibilities. The average cost to U.S employers of full-time employees who are caregivers totals $33.6 BILLION per year in lost productivity. (Preparing Minnesota for Alzheimer's , 2011). These staggering numbers identify a critical need for supporting caregivers to manage their stress through education, training, and supportive services.

In 2013, First Nations Home Health, in collaboration with C&V Senior Care Solutions, integrated a comprehensive home care program called Becoming an Alzheimer’s Whisperer. Paid completely through the Medicare home care benefit, Becoming an Alzheimer’s Whisperersupports the person, the caregiver and, the family to manage the diagnosis and the challenges that surround it. Becoming an Alzheimer’s Whisperer teaches families to understand how the disease affects the brain and enable the caregiver to enter the world of the person who has dementia or Alzheimer’s. Caregivers are trained to handle behaviors which include uncooperative behavior, agitation, aggression, wandering, sun-downing, sexually acting-out, dressing and bathing difficulties, eating difficulties, repetitive behaviors, and more. The program incorporates a multi-disciplinary approach and utilizes Skilled Nurses, Occupational Therapists, Physical Therapists, Social Workers, and Speech Pathologists. It uses standardized evidence-based teaching and assessment tools, and is based on the theory of Retrogenesis, developed by Dr. Barry Reisberg. Retrogenesis means "back to birth”, which concludes that Alzheimer's unravels the brain almost exactly in reverse order as the brain developed from birth. This foundational understanding provides a method of creating approaches, environments, and techniques based on the developmental stage that correlates with the stage of dementia. The patient and the Caregiver will demonstrate competent self-care skill management of Alzheimer's disease including a full range of behavioral, physical, social, and spiritual implications of this disease in order to remain safe at home.

By initiating supportive services upon diagnosis or at the initial onset of problematic behaviors, families receive help before it reaches crisis level. This proactive approach can successfully increase the quality of life for patients and their families affected by this dynamic disease.

-Shannon MacKenzie Area Manager HealthStar/First Nations Home Health

]]>Alzheimer’s Disease and Sundowninghttp://firstnationshomehealth.com/first-nations-home-health-blog/alzheimers-disease-and-sundowning/
http://firstnationshomehealth.com/first-nations-home-health-blog/alzheimers-disease-and-sundowning/Mon, 27 Apr 2015 14:34:49 GMTDo you know someone with Alzheimer’s disease or dementia that is complaining of sleep issues or nighttime restlessness? Have you noticed behavioral changes beginning at dusk that seem to last into the night? This person may be experiencing a condition known as sundowning.First Nations Home HealthDo you know someone with Alzheimer’s disease or dementia that is complaining of sleep issues or nighttime restlessness? Have you noticed behavioral changes beginning at dusk that seem to last into the night? This person may be experiencing a condition known as sundowning. The term “sundowning” refers to a state of confusion at the end of the day and into the night. Sundowning has been known to cause a variety of behaviors, including confusion, aggression or a tendency to ignore direction. Wandering and pacing are also common symptoms that may occur.

Although scientists don’t fully understand why, studies show that up to 20% of persons with Alzheimer’s disease or dementia experience sleep changes and a mixed-up internal body clock. This seems to happen, along with changes in memory and behavior, as a result of the impact of Alzheimer’s on the brain. Sundowning is not a disease, but rather a variety of symptoms that tend to occur later in the day.

Plan more active days - take a walk or engage in other physical activity.

Restrict caffeine consumption to the morning hours.

Reduce the background noise and stimulating activity, including TV viewing, in the evening.

Keep distractions to a minimum.

Limit activities during the late afternoon and early evening to those that are simple and relaxing.

If pacing or wandering occurs don’t use physical restraint. Instead, allow the pacing to continue with your supervision. Interfering with this may cause an outburst or aggression.

If you have a family member or are caring for someone experiencing sundowning, it is helpful to document routines and look for patterns. Is it happening only at certain times of the day or when certain people are around? Do certain events trigger the symptoms? If you are able to recognize the ‘trigger’ you may be able to reduce the frequency of occurrences. Also, maintaining a regular schedule of meals, waking and bedtime routines is one of the most common coping strategies for sleep issues and sundowning and will allow for a more restful sleep at night.

Dr. Verna Benner Carson, President of C&V Senior Care Specialists, Inc. and a board certified clinical nurse specialist in psychiatric mental health nursing, recognizes the importance of knowing the person’s story or history. “This greatly assists the caregivers to provide meaningful activities that draw on old memories”, she said. Dr. Carson also believes that patience and flexibility are two of the most important qualities that a caregiver can possess, allowing the caregiver to work with the patient to provide calming situations and reduce any frustration or agitation. “Repetition which can drive caregivers to respond with irritation and anger can be easily redirected into repetitive activities such as folding laundry for women or sorting nuts, bolts, and screws for men”, she suggests.

Caring for a loved one with Alzheimer’s disease or other dementias can be very difficult. One great resource available is the Alzheimer's Speaks website. Founder Lori La Bey's goal is to shift the dementia care culture from crisis to comfort around the world by changing how we give and receive care. Lori views the globe as one large cradle which is here to nurture those in need, as life ebbs and flows through the stages of aging. Lori, and Alzheimer's Speaks, hosts a variety of memory & Alzheimer's cafes, dementia chat webinars, and even a radio show to help those with dementia struggles and those who care for them.

First Nations Home Health understands how overwhelming and difficult it can be to care for a loved one with Alzheimer's or dementia and offers a comprehensive and effective Alzheimer’s and dementia home care program in our Alzheimer’s Whisperer program. This care program is a unique and effective approach to support those affected by Alzheimer’s disease and other dementias and their family. For additional information on dementias and caregiving, visit our website at www.firstnationshomehealth.com.

]]>Meeting of the Minds Help to Connect the Heartshttp://firstnationshomehealth.com/first-nations-home-health-blog/meeting-of-the-minds-help-to-connect-the-hearts/
http://firstnationshomehealth.com/first-nations-home-health-blog/meeting-of-the-minds-help-to-connect-the-hearts/Mon, 06 Apr 2015 14:08:24 GMTThe Meeting of the Minds Dementia Conference was at the Riverside Convention Center in downtown St. Paul on March 12, 2015 … and HealthStar/First Nations Home Health was there! First Nations Home HealthThe Meeting of the Minds Dementia Conference was at the Riverside Convention Center in downtown St. Paul on March 12, 2015 … and HealthStar/First Nations Home Health was there! Hosted by the Alzheimer’s Association Minnesota-North Dakota Chapter and Mayo Clinic, the conference draws over 1,300 participants and over 70 sponsors and exhibits. Imagine a convergence of persons with dementia, family caregivers and professionals all learning, sharing and networking. The passion to provide the best care, identify resources and support for those in need of Alzheimer and dementia care was palpable.

Nilda of HealthStar with Lucinda Hochsprun

The most memorable moment of the day for the HealthStar/First Nations team was when Lucinda Hochsprung visited our exhibit. She shared that she attended the conference last year and learned about First Nations’s Alzheimer’s Whisperer program. With much appreciation for the First Nations team and what she learned, Lucinda shared, “I found HealthStar's Alzheimer’s Whisperer information very helpful with my Dad.” It was a touching moment that affirmed the importance of the services that are provided and the lives that are positively touched by HealthStar/First Nations.

First Nations understands how overwhelming and difficult it can be to care for a loved one with Alzheimer’s or other Dementias. Our multidisciplinary team provides a comprehensive and effective Alzheimer’s and Dementia Home Care Program, so you can care for your loved one at home or an Assisted Living setting. In addition to the “Becoming an Alzheimer’s Whisperer ” program, First Nations also offers the Memory Café for individuals with early memory loss. It’s an opportunity for everyone to come together to share stories and laughter with supportive resources in an environment that is understanding. After all, our loved ones with Alzheimer’s and dementia deserve as much love, understanding, compassion and support that we can provide.

To learn more about the Meeting of the Minds Dementia Conference, click here. To learn more about First Nations Home Health's Alzheimer's Whisperer Program, please visit our Alzheimer's and Dementia page.

]]>Diabetes and the Native American Populationhttp://firstnationshomehealth.com/first-nations-home-health-blog/diabetes-and-the-native-american-population/
http://firstnationshomehealth.com/first-nations-home-health-blog/diabetes-and-the-native-american-population/Mon, 23 Mar 2015 13:49:18 GMTThe numbers are alarming. 40% of Native Americans in Minnesota have diabetes according to Lori Watso, a former public health nurse and Shakopee tribe member as quoted in a Star Tribune article. This epidemic will continue to expand as Native Americans are nearly twice as likely as whites to become obese, more than twice as likely to have Type II diabetes and, among children, the rate of obesity and diabetes will soon reach 50% according to a report by the Shakopee Mdwakanton Sioux Community. First Nations Home HealthThe numbers are alarming. 40% of Native Americans in Minnesota have diabetes according to Lori Watso, a former public health nurse and Shakopee tribe member as quoted in a Star Tribune article. This epidemic will continue to expand as Native Americans are nearly twice as likely as whites to become obese, more than twice as likely to have Type II diabetes and, among children, the rate of obesity and diabetes will soon reach 50% according to a report by the Shakopee Mdwakanton Sioux Community. Not limited to a few tribes living on reservations, the entire northern part of Minnesota contains four of the five least healthy counties where two-fifths of the population in Mahnomen County (least healthy) is Native American, 11.9% in Cass (#2) and 20.8% in Beltrami (#5). This according to County Health Rankings from the Robert Wood Johnson Foundation and the University of Wisconsin). These numbers are not at all surprising to us here at First Nations Home Health as it's a common health issue we treat. Karen Moses, RN Case Manager in our greater Minnesota branch location says that 90% of her clients have diabetes and 99% are Native American. By offering home health care services on the Red Lake, White Earth, Leech Lake, Bois Fort, Fond du Lac and Mille Lacs Reservations, we see firsthand the affects of diabetes and are working to empower patients and their families to be active participants in the solution.

Risk Factors

ObesityWith an abundance of fat cells in the body, insulin cannot do its job which is to take glucose (sugar) out of the bloodstream and pack it into healthy cells. Gaining as little as 10 pounds over 15 years can double your insulin resistance and increase your risk of diabetes. Obese adults are seven times more likely to develop diabetes compared to adults at a healthy weight. But, for the Native American population, what causes obesity?

Poor NutritionPrior to the Civil War, Type 2 diabetes was practically non-existent. Following the war, Indians were forced onto reservations and the government began providing food commodities according to Devon Abbott Mihesuah, a member of the Choctaw Nation of Oklahoma who runs the American Indian Health and Diet Project at the University of Kansas. Wild rice and grains gave way to flour, processed cheese and macaroni and low fat meats such as fish, deer and rabbit was replaced by beef and pork.

Sedentary LifestyleAlso prior to the Civil War, Native Americans lived off the land which kept them active with fishing, harvesting, gathering and trapping. With the lack of a replacement to these activities and acquisitions of motorized vehicles, a once active community found themselves sitting often with very little exercise.

GeneticsThe thrifty gene hypothesis penned by James V. Neel states that some populations have genes which enable them to efficiently maintain higher levels of healthy fat during periods of food abundance that is depleted during periods of shortage (feast and famine). While this hypothesis has often been disputed, the activity and types of foods involved with storing food for the winter do give credence to a difference in lifestyle. Genetic markers and body type also indicate a genetic predisposition to diabetes.

AlcoholismAccording the Indian Health Services, the rate of alcoholism among Native Americans is six times the U.S. average. Alcohol is often high sugar and carbohydrates which quickly turns into fat. Depression is associated with alcoholism which leads to a host of other health factors.

Treatments

MedicationPills and insulin injections are the most commonly prescribed treatments. It is still up to the patient to take the medication which can be an issue.

Nutrition ProgramsResidents at the Little Earth of United Tribes are growing food common to their ancestors which they call the "decolonized diet" according to a Star Tribune article. Nutrition counseling that we offer through First Nations Home Health Care includes reading labels and eating all 5 food groups in moderation.

Exercise ProgramsChildhood obesity is prevalent int the Native American Population. To combat this, the diabetic fitness center at the reservation on Leech Lake, MN holds fitness programs, camps and a walk-a-thon to bring awareness to the issue. Members can get a doctor's prescription to use the center safely and employees of the tribal government are given a 30 minute break per day specifically to exercise.

Dangers if Not TreatedIf diabetes is not treated or properly controlled, the body starts eating away at muscle as it tries to burn muscle for energy. Other health issues that could occur:

Neuropathy (numbness) in feet & toes

Ulcers

Gangrene

Blindess

Damage to eyes, kidneys and liver

Even with all of these treatments, the epidemic is getting worse. That is why the Shakopee Mdewakanton Sioux Community is partnering with the University of Minnesota and two other nonprofits to launch Seeds of Native Health whose goal is to offer better access to healthy food which focusing on education and research. Here at First Nations, our Native American-specific program offers equitable access to health care in order to reduce health disparities in diverse communities. Our cultural competence program, the 24ECC, internalizes the values of those we serve.

]]>Connecting with our Communityhttp://firstnationshomehealth.com/first-nations-home-health-blog/connecting-with-our-community/
http://firstnationshomehealth.com/first-nations-home-health-blog/connecting-with-our-community/Mon, 16 Mar 2015 13:43:23 GMTReaching out and giving back was the theme of the day at the Minneapolis Urban League (MUL)’s Employer of the Day event held on Wednesday, February 25, 2015. In collaboration with MUL’s Business Employment & Solutions Training (BEST) program, HealthStar/First Nation’s South Minneapolis team took the opportunity to connect with other employers, participants and the community.First Nations Home HealthReaching out and giving back was the theme of the day at the Minneapolis Urban League (MUL)’s Employer of the Day event held on Wednesday, February 25, 2015. In collaboration with MUL’s Business Employment & Solutions Training (BEST) program, HealthStar/First Nation’s South Minneapolis team took the opportunity to connect with other employers, participants and the community.

BEST offer training as Health Unit Coordinator, Certified Nursing Assistant, Health Information Technology and other trades, while also enhancing the participant’s soft skills and emotional intelligence. “Building & maintaining those bridges to our community are essential to better understand potential HealthStar/First Nations team members and best serve our clients. Recruiting within the communities we serve allows us to connect with BEST graduates and pair them with our clients in a meaningful way,” stated Xaulanda Simmonds-Emmanuel, Branch Manager, HealthStar/First Nations Home Health.

The collaboration with BEST provides a perfect opportunity to recruit individuals that have successfully completed the program. Focused on such qualities as Integrity, Responsibility, Commitment to Quality, Flexibility/Adaptability and other viable contributions, the intent is directly aligned with First Nation’s Expressions of Corporate Culture. Further, it offers a gateway to opportunity for graduates to become gainfully employed and connect to the community by offering quality home health services.

]]>Wound Carehttp://firstnationshomehealth.com/first-nations-home-health-blog/wound-care/
http://firstnationshomehealth.com/first-nations-home-health-blog/wound-care/Mon, 16 Feb 2015 13:40:35 GMTOne of the skilled services we provide is in-home wound care. Providing good wound care and wound care education plays an essential in role in assuring a faster recovery time with reduced risk of complications. First Nations Home HealthAt First Nations Home Health, our team of caregivers, which includes nurses, case managers and therapists provide services that help people stay at home in familiar surroundings, develop good health habits and reduce hospitalizations. One of the skilled services we provide is in-home wound care. Providing good wound care and wound care education plays an essential in role in assuring a faster recovery time with reduced risk of complications. First Nations Home Health uses a team approach including registered nurses, home health aides and physical and occupational therapists along with the latest evidence based practice to promote wound healing and prevent complications.

There are various types of wounds and methods to treat them. Our First Nations team knows that each wound is unique, and realizes the importance of staying on top of the latest care techniques and treatments so they are prepared for anything. Here is some information about the more commonly treated types of wounds:

Pressure Ulcers (bed sore): Pressure ulcers are injuries to skin and underlying tissue resulting from prolonged pressure on the skin and usually develops on the skin that covers bony areas of the body, such as the ankles, heels, hips and tailbone. Pressure ulcers can develop quickly and are often difficult to treat. Pressures ulcers left untreated can cause serious health complications such as sepsis, cellulitis and bone and joint infections. Pressure ulcers are diagnosed in stages and the treatments vary depending on the stage. We work with the client’s primary physician and/or wound care clinics to assure best practices and treatment. Under the direction of the physician, we can provide hands on assistance with dressing changes and teach different techniques to promote wound healing. We also provide other hands-on assistance and education regarding pain management, antibiotics, nutritional education for promoting wound healing and managing incontinence. Some physicians will order Wound Vac Therapy to promote quicker healing.

Diabetic Ulcers: A diabetic foot ulcer is an open sore that occurs in approximately 15% of diabetic patients and is commonly found at the bottom of the foot. Of those who develop a foot ulcer, 6% will be hospitalized due to infection or other complication related to the foot ulcer. Nutrition and hydration are keys to preventing diabetic ulcers. Staying on top of diet and hydration will also help control the diabetes. If you are treating a foot ulcer, cleansing the wound daily is important to prevent infection, other complications or even hospitalization. Research has shown that developing diabetic ulcers is very preventable, but if left untreated or symptoms are ignored, the foot ulcer can lead to more serious conditions or even amputation.

Stasis Ulcers: A stasis ulcer is an ulcer that develops in an area of the body where circulation is sluggish and the return of blood to the heart is poor. Stasis ulcers commonly develop on the ankle when fluid leaks from the veins into skin tissue when the blood backs up rather than returns to the heart through the veins. To prevent a stasis ulcer, be sure to elevate the legs to relieve the edema (swelling caused by excess fluid build-up).

Surgical Wounds: A surgical wound is a cut or incision on the skin made during surgery. Sometimes a drain needs to be placed during surgery and this is also considered a surgical wound. They are usually closed with sutures or staples but occasionally left open to heal. We assist and teach signs and symptoms of wound infection such as excessive and foul smelling drainage, increased pain or warmth. We can also remove the sutures and staples when needed.

Treatment:Much attention is given to preventing such injuries and ulcers, but even with stringent prevention techniques, ulcers and wounds still occur and need to be cared for properly. There are various treatments and techniques First Nations Home Health uses to treat wounds. Our care team follows evidenced based practice, which follows the principals of moist wound healing. Since not all wounds are alike and treatment needs to address the unique characteristics of the wound and the needs of the client, the first step is a comprehensive assessment. Following the assessment the clinician in collaboration with the physician determine the proper treatment and dressing to achieve optimal wound healing. The goal is to pick the right product on the right wound at the right time. The First Nations wound care team has their “go-to” products that, through years of experience, have been proven to be highly effective in treating wounds. Silver offers the wonder drug of creams along with other high quality products and dressings. We are also forward thinking and willing to try more natural products which is how we found MEDIHONEY® made from medical-grade honey.

In addition, all of our nurses are specially trained to provide Wound VAC Therapy, which promotes wound healing through negative pressure. A GranuFoam Dressing is applied to the wound bed and is secured by a sterile, occlusive dressing and a small tube is attached which connects to a small vacuum type pump and uses mechanical forces to the wound to create an environment that promotes wound healing. This is usually changed 3 times weekly by a registered nurse. This is a very effective way to heal wounds.

Home health care for wounds is covered by many insurance plans. First Nations Home Health can assist with contacting your insurance companies to see what type of coverage you have available for these types of services. For Medicare beneficiaries, who meet the qualifying home health criteria, i.e.: homebound, Medicare will cover clinicians to come to your home to provide wound care and the required supplies.

First Nations Home Health practices a team approach to patient care, led by an RN who will coordinate the necessary disciplines. They know the importance of collaboration, communication, and including the family in training and discussions to ensure they provide the best care for your loved one.

]]>A Day in the Life of a Psychiatric Field Nursehttp://firstnationshomehealth.com/first-nations-home-health-blog/a-day-in-the-life-of-a-psychiatric-field-nurse/
http://firstnationshomehealth.com/first-nations-home-health-blog/a-day-in-the-life-of-a-psychiatric-field-nurse/Mon, 19 Jan 2015 13:36:44 GMTFirst Nations Home Health

7:00 am: Amelia Muir, psychiatric home care nurse begins her day by logging into her laptop. After checking e-mails and confirming appointment times with patients, Amelia is ready to enter the field for her four scheduled home visits in Queens, New York. Queens, a borough of New York City, is home to more than 2 million residents and is considered one of the most diverse areas in the country.

8:00 am: Amelia’s first visit is to see Ms. A., a 62-year-old woman who has been living with HIV for the past 25 years. Ms. A. was referred to Amelia by her caseworker, who noticed signs of depression and anxiety following a recent hospital admission. For the first 30 minutes of the visit, Amelia provides counseling to Ms. A. using cognitive behavioral therapy techniques, which aim to help her reframe negative thought patterns and begin to change ineffective coping mechanisms. After her patient has had the opportunity to express her feelings openly, Amelia shifts the visit to focus on specific symptoms she and Ms. A’s doctors have been closely monitoring. The home care visit is a vital way to keep doctors updated on a patient’s condition as many patients feel certain symptoms are either not important enough to call their doctors or nurses about.

The last 15 minutes of Amelia’s visit with her patient focuses on goal setting and educating the patient about her recommendations for whatever issue they had been discussing. In addition to patient-centered goal setting, Amelia also adds her own suggestions, such as taking a walk around the neighborhood with the home health aide for exercise and stress relief, calling an old friend, or taking time to sit down with a good book. “Many of my depressed patients are in need of more joy in their lives. It may seem overly simple but with the right frame of mind, escaping into a novel or a hobby can have noticeable effect on someone’s mood.” To close the visit, Amelia reviews a list of important symptoms to report to her nurse or doctor with Ms. A. Establishing good communication between patient, nurse, and doctor helps prevent hospitalizations by addressing issues at the earliest appearance. Ms. A. tearfully hugs Amelia at the end of most visits and thanks her for her support. The authentic relationship established between clinician and patient after weeks or months of working together cannot be understated.

Back in her car and mobile office, Amelia checks voicemails and e-mails from other clinicians and patients. Between every visit, arise that require careful coordination. It is often said in the office that being in the patient’s home is the easy part, meaning the real work is often done by clinicians behind the scenes. The case management aspect of home care nursing can drive the stress level up in this specialty.

10:00 am: Amelia’s next patient is Ms. G., a 74-year-old who is experiencing a high level of anxiety because of her progressing amyotrophic lateral sclerosis disease. Amelia has been coming for several weeks after Ms. G.’s daughter begged her to accept psychiatric treatment when she noticed her mother’s motivation to care for herself significantly declined. The first half of the visit is again focused on allowing the patient to have time to express her feelings openly to her nurse. Ms. G. describes how her breathing has become more difficult. One of the interventions Amelia teaches her is how to preform deep abdominal breathing exercises to decrease anxiety and improve lung expansion. She also recommends that Ms. G. play classical music during this exercise to give an added stress-relieving quality. After reviewing goals for the week and target symptoms to report, Amelia begins a short relaxation exercise with the help of aromatherapy oils and acupressure. “I love home care because I have more flexibility to try different strategies with my patients.” Using a simple acupressure technique on both hands creates a calming sensation for Ms. G. She teachers her how to use this technique on her own.

Technology is also an important part of Amelia’s teaching strategies for patients who have access to computers or tablets. Ms. G. was an accountant before she retired 3 years ago and is part of a growing group of tech-savvy seniors. On and earlier visit, Amelia helped Ms. G. explore Web sites, such as YouTube, that provide free instructional videos on topics relevant to the wellness teaching she provides including guided meditation, chair yoga for seniors, and breathing exercises. Ms. G. is also learning to use her tablet for recreation, “I love the videos of the New York City Ballet. It brings me back to when I could move like that!”

1:00 pm: At a nearby apartment complex, Amelia greets her next patient’s wife, who is the primary caregiver for her husband. Mr. C. is in the middle stages of Alzheimer’s disease and has been experiencing many behavioral changes that have caused great stress for his wife. Amelia sits down with the couple in their brightly lit kitchen and reviews symptoms over the past week. During her visits, Amelia explains the different stages of his illness, communication techniques, safety precautions, tips for managing insomnia, and encourages Ms. C. to keep her husband’s mind stimulated with structured activities and recreation. Another important topic Amelia covers is caregiver burnout and she encourages Ms. C. to take time for herself whenever possible.

3:00 pm: For her last visit, Amelia visits Mr. B., a man in his late 50s who is now homebound as a result of Parkinson’s disease. Despite increasing physical challenges, Mr. B. is determined to stay as independent as possible and spends 3 days per week doing intensive treatments with a physical therapist. Amelia visits this patient every 2 weeks to fill his medication box as muscle weakness in his hands prevents him from doing this for himself. Mr. B. updates Amelia on symptoms over the past week and excitedly discusses his progress with his rehabilitation program. Amelia finishes the visit with a quick check on his vital signs.

At the end of her visit, Amelia returns back to her car to make the trek back to her home where she will complete her visit notes and make some final calls to doctors. After another emotion-filled day, Amelia tries a breathing exercise of her own. “Helping patients with depression and anxiety can take an emotional toll on clinicians and it’s vital for me to have self-care rituals so that I don’t become burned out,” adding “I want to do this work for the rest of my career and my goal is to take good care of myself along the way.”

Written by Amelia Muir, BSN, RN-BC

Amelia Muir is a Psychiatric Field Nurse, Behavioral Helath, Visiting Nurse Service of New York, New York City, New York.

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http://firstnationshomehealth.com/first-nations-home-health-blog/managing-alzheimers-behaviors/Mon, 05 Jan 2015 18:50:18 GMTWhether you have cared for someone with Alzheimer’s in their Minnesota home for many years or have just learned that a loved one has been diagnosed with the disease, managing their behavior and personality changes can be very challenging. You may have already figured out that, as a caregiver, you cannot change the person with Alzheimer’s, or any type of dementia, but you can develop strategies to help you better manage any problem behaviors.First Nations Home HealthWhether you have cared for someone with Alzheimer’s in their Minnesota home for many years or have just learned that a loved one has been diagnosed with the disease, managing their behavior and personality changes can be very challenging. You may have already figured out that, as a caregiver, you cannot change the person with Alzheimer’s, or any type of dementia, but you can develop strategies to help you better manage any problem behaviors. According to the Alzheimer’s Association, Alzheimer’s is a type of dementia that causes problems with memory, thinking and behavior. Alzheimer’s is the most common form of dementia and symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.

It’s important to know that the patient is not trying to be difficult. Instead their behavior is often a reaction to stress or frustration in an attempt to communicate. Creating a calming routine and environment for the patient at home along with the way you communicate with them will make a huge difference. The Alzheimer’s Association offers their top five tips that can help you manage your loved one’s behaviors.

Try not to take behaviors personally.

Remain patient and calm.

Explore pain as a trigger.

Don’t argue or try to convince.

Accept behaviors as a reality of the disease and try to work through it.

Keeping these tips in mind when caring for a loved one or patient with Alzheimer’s is important. At First Nations Home Health, we offer many services and programs to assist with the care of those struggling with Alzheimer’s or other types of dementia. One service we offer is psychiatric home care. This specialty is holistic in its approach, assessing for and addressing the total needs of the patient – physical and emotional. Not only does the patient benefit, the family also benefits by learning new skills to help their loved one remain stable. The health care system benefits from psychiatric home care by maintaining the patient who struggles with persistent psychiatric issues in the least restrictive (and least expensive) setting, which is the home.

First Nations also offers support for those with Alzheimer’s and dementia through our Alzheimer’s Whisperer program. We understand how overwhelming and difficult it can be to care for a loved one with Alzheimer’s or other types of dementia. Confusion, exhaustion and frustration are all common when trying to manage challenging behaviors associated with these illnesses. First Nations Home Health developed a comprehensive and effective Alzheimer’s and dementia home care program, and is proud to offer this program to assist the caregivers and patients alike. Becoming an Alzheimer’s Whispereris a unique approach to help support those affected by dementia that live in a home or assisted living setting. The Alzheimer’s Whisperer program is based on the understanding of how the disease affects the brain allowing caregivers to modify interventions so they are appropriate for the person’s cognitive ability. Services are provided by a multidisciplinary team consisting of registered nurses, physical therapists, occupational therapists, medical social workers, speech pathologists and home health aides, who work together to improve the quality of life for the caregiver and their loved one.

Other care services we at First Nations Home Health offer are:

Individualized assessment, evaluating cognitive and functional levels

Treatment planning

Care for patients in a compassionate, empathetic and gentle manner

Teach families and caregivers strategies for managing the care needs of their loved one

Effectively respond to challenging behaviors such as aggression, agitation, and repetition

Address physical health needs

Medication management and education

Reduce utilization of psychotropic medication

Strength development and fall risk reduction

Promote independence in dressing, bathing and toileting

Assistance with memory, communication and swallowing difficulties

Although your loved one’s sense of what is real may be different than yours, it is still very real to them. By learning to manage the behavior changes you will find yourself reaching some pretty significant goals in the care of your patient. You may notice decreased hospitalizations or use of emergency services, improved functional ability and patient knowledge about their medications, treatment compliance and staying well. All of which can increase your loved one’s quality of life and overall health management.

As a caregiver, even being able to maintain your sense of humor will go a long way in managing the changing behavior of a loved one suffering from Alzheimer’s. When that isn’t doing the trick, we at First Nations Home Health are here for you with expert services and programs available to help you through the stages of progressing Alzheimer’s.